Hi Joel,

I've been on 100-200mg/week TRT for 5 years. TT levels have been supraphysiological for about half the time, and while there are obvious benefits to the higher levels, I'm concerned I might be putting my long term health at risk.

My doc regularly tests liver enzymes, E2, CBC, Hematocrit, cholesterol and PSA which have all looked good except I'm noticing a trend that my Alkaline Phosphatase is getting lower. It was most recently 29 LOW (39-117 IU/L), before that 32, 35, and 37 respectively. I believe it was around 50 before TRT.

My doc doesn't seem concerned about this, but I also wonder if he is ignoring it because other labs look good. While I feel fine, this is a little concerning because I can't pinpoint anything in my diet that could be causing it. I don't have any known mineral deficiencies in zinc, magnesium, calcium, phosphorus. I take supplements for these and eat lots of protein and fish. One thing that is interesting is that my weight has gone up about 15 lbs without me looking visibly bigger. I attribute this to possible increase in bone density, which apparently is correlated with lower Alkaline Phosphatase. However, it seems odd that Alkaline Phosphatase hasn't stabilized by now.

In your opinion, should I be concerned? Does this warrant further testing? I suspect if I were truly sick, I'd have some negative symptoms.